<Unavail>

LBN: Broulim Supermarkets, Llc
<Unavail> is an health care organization with primary practice located at 1855 W Broadway St , Idaho Falls ID 83402-3043. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Clinic Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Broulim Supermarkets, Llc can be contacted via phone (208) 529-3638, or through Hurst, Marcus via phone (208) 745-9201.

Contact Information

Primary practice address
1855 W Broadway St Idaho Falls ID 83402-3043
Fax: (833) 887-9907
Website:
Authorized official contact:
Name: Hurst, Marcus PHARMD

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Clinic Pharmacy 3336C0002X
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1487117636
LBN Legal business name Broulim Supermarkets, Llc
DBA Doing business as <Unavail>
Authorized official Hurst, Marcus PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Apr 12th, 2019
Last updated Jul 3rd, 2025 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487117636 NPPES
Other 1309966 NCPDP
MEDICAID 1487117636 NCPDP
Other 53248RP NCPDP

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